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Cartilage destruction is considered a hallmark of OA and is a result of increased production of catabolic effectors 32,33,34,35 and reduced matrix biosynthesis by chondrocytes 36

Limiting Alcohol: Excessive alcohol consumption affects the Leydig cells in the testis, which are responsible for testosterone production and secretion

Its use leads to increased endurance, improved heart function, increased muscle mass by accelerating metabolic processes in cells, improving the penetration of vitamins, minerals and excretion of breakdown products, reducing the risk of fatty liver disease

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Thanks The Nice guidelines are for NHS prescriptions and based on cost saving re hydroxocobalamin as it was costed in the 1980's

Keep in mind the injections are not a replacement for diet and exercise